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pharm III exam 2 > GOUT > Flashcards

GOUT Flashcards

1
Q

indomethacin

A
  • NSAID
  • primary NSAID used in tx Acute gouty Attacks
  • Nonspecific reversible inhibitors of COX01 and COX-2 enzymes
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2
Q

naproxen (Naprosyn)

A
  • NSAID
  • tx Acute gouty Attacks
  • Non-specific reversible inhibitors of COX -1 and COX-2 enzymes
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3
Q

Colchicine

A
  • Used for acute gout attacks
  • binds to tubulin; inihbits assembly of microtubules -> produces anti-inflammatory effect by preventing phagocytosis
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4
Q

probenecid (Benemid)

A
  • Uricosuric agent
  • tx of hyperuricemia
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5
Q

allopurinol (Zyloprim)

A
  • Xanthine oxidase inhibitor thus inhibits synthesis of uric acid
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6
Q

pegloticase (Krystexxa)

A
  • mammalian urate oxidase enzyme that converts uric acid to allantoin
    • ​readily excreted
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7
Q

rasburicase (Fasturtec)

A
  • recombinant form of urate oxidase (not endogenous in humans) that converts uric acid to allantoin
    • ​readily excreted
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8
Q

gout patients may be of what two types

A
  • overproducers of uric acid
  • underexcreters
    • renal excretion of uric acid is low
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9
Q

problem with hyperuricemia?

A
  • uric acid not water soluble so in big concentrations will come out of solution and form crystals which produce inflammatory response
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10
Q

urate crystals are by synoviocytes, initiating an inflammatory reaction mediated by prostaglandins and cells of the immune system

A
  • phagocytosed
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11
Q

can aspirin be used to treat gout

A
  • asa, salicylates are contraindicated
  • they decrease urate excretion in the kidney
    • both acids
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12
Q

Treatment of patient with

  1. active PUD
  2. not active PUD
  3. No hx of PUD
A
  1. acetaminophen or opioids **no NSAIDs,
  2. celecoxib
  3. NSAIDs
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13
Q

which drugs can be used in the acute treatment of gout

A
  • NSAIDs
    • indomethacin
  • Colchicine
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14
Q

how can glucocorticoids be used in the treatment of gout

A
  • inhibit phospholipase A2 which is responsible for arachidonic acid, the rate limiting step in synthesis of prostaglandins
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15
Q

how long does it take for Colchicine to be effective

A
  • 12-24 hours
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16
Q

adverse effects of Colchicine

A
  • diarrhea
17
Q

function of uricosuric agents

A
  • incrase the urinary excretion of uric acid by blocking the active reabsorption of uric acid in the proximal tubule
18
Q

why should a large volume of be probenecid (a uricosuric agent) used

A

in order to minimize the possibility of kidney stone formation

19
Q

iniitial administration of probenecid may do what

A
  • trigger gouty attack
  • combine with colchicine - prophylactic colchine therapy
20
Q

side effect of probenecid

A
  • Decrease excretion of acidic compounds (penicillin, methotrexate)
21
Q

when should probenecid therapy be started

A
  • should not be started until 2-3 weeks after an acute attack
  • may aggrevate gout symptoms if given during acute attack
22
Q

MOA of Febuxostat (uloric)

A
  • inhibits xanthine oxidase and thus inhibits synthesis of uric acid
23
Q

side effects of xanthine oxidase inhibitors

A
  • vasculitis
  • agranulocytosis
24
Q

what should you consider when starting xanthine oxidase inhibitor therapy

A
  • initial therapy may provoke acute gouty attack,
  • colchicine proplhylaxis may be necessary
25
Q

what effect does aluminum hydroxide and other antacids have on xanthine oxidase inhibitors (allopurinol, febuxostat)

A
  • decreases their absorption
26
Q

what effect does the xanthine oxidase inhibitors (allopurinol, febuxostat) have on mercaptopurines (chemotherapy drug)

A
  • increases their effect
27
Q

what effect does the xanthine oxidase inhibitors (allopurinol, febuxostat) have on warfarin

A
  • inhibits the metabolism of warfarin
28
Q

how is rasburicase (Fasturtec) administered

A
  • IV
29
Q

adverse reaction of rasburicase (Fasturtec)

A
  • severe hypersensitivity: anaphylactic shock

pharm III exam 2 (10 decks)

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